Alexandrino Henrique, Fernandes Miguel, Ferreira Luis, Tralhão J Guilherme, Castro E Sousa Francisco
Serviço de Cirurgia A dos Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra - Clínica Universitária de Cirurgia 3 da Faculdade de Medicina da Universidade de Coimbra, Portugal.
Rev Port Cir Cardiotorac Vasc. 2012 Jan-Mar;19(1):27-9.
Esophageal foreign body impaction is mostly managed with endoscopic retrieval. However, in cases of large or irregularly shaped foreign bodies, or in cases of long standing impaction, this technique carries a high risk of perforation and a surgical approach is often mandatory.The authors report the case of a 55 year old woman, with a past history of mental retardation, presenting with dysphagia for solid food and regurgitation beginning one month earlier. After failed extraction by flexible esophagoscopy,the denture was removed by esophagotomy through a postero-lateral thoracotomy. In the postoperative period the patient developed a leakage of the suture line with resultant esophago-pleural fistula which was managed with double esophageal exclusion. She was discharged on the 40th postoperative day on semi-solid diet and is presently (eight months after the first surgery) symptom free.
食管异物嵌顿大多通过内镜取出进行处理。然而,对于大型或形状不规则的异物,或长期嵌顿的情况,这种技术存在较高的穿孔风险,手术方法往往是必要的。作者报告了一例55岁女性病例,该患者有智力发育迟缓病史,一个月前开始出现固体食物吞咽困难和反流症状。经柔性食管镜取物失败后,通过后外侧开胸食管切开术取出假牙。术后患者出现缝线处渗漏,导致食管胸膜瘘,通过双重食管闭锁进行处理。术后第40天,患者出院,进食半固体食物,目前(首次手术后八个月)无症状。